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Introduction Coronavirus disease-2019 is a worldwilde pandemic not limited to pulmonary dysfunction. it is a systemic infection responsible for serious coagulopathies. Case presentation We report the case of a patient who presented an acute ischemia of the left lower limb, after day 5 of (Covid-19) infection, with a second thrombotic localization in the left upper limb at the twentieth day of post covid while he was on anticoagulation. Clinical discussion Several studies have shown the involvement of the inflammatory process in the thrombotic state in patients with (Covid-19) infection. The inflammatory process leads to the activation of the thrombotic cascade. Various elevated markers have been identified frequently and described to determine the progression of sepsis-induced prothrombotic disease secondary to Covid-19. Our case remains unique in its kind, since the patient presented twice the acute ischemia of the limbs, the first at the left lower limb, while he was on preventive low molecular weight heparin (LMWH), the second time at the left upper limb, while he was on anticoagulation (RIVAROXABAN 20 mg/jr). Although the efficiency of preventive anticoagulation in Covid-19 patients has not been established, it remains systematic as a prescription in the hospital environment. Conclusion All in all, The regular monitoring of vascular markers thrombosis, and preventive anticoagulation remains the only weapon available to any clinician to fight against vascular thrombotic complications in Covid-19 patients, though its realiability has not been proven.

Introduction Acute kidney injury (AKI) is commonly seen in critically ill hospitalized patients with COVID-19 and its incidence reaches 60% in this setting. The aim of this work was to determine the prevalence, characteristics, risk factors and mortality of AKI in patients admitted to the intensive care unit (ICU) for COVID-19. Patients and methods This observational retrospective case series was conducted between February 1, 2020 and December 31, 2020 at the ICU of the university hospital Mohammed VI of Oujda, Morocco. all COVID-19 patients hospitalized in the ICU with acute respiratory failure were included. AKI was defined and classified into three stages using the KDIGO criteria 2012. We excluded patients with end-stage kidney disease and those who were under 18 years old. Results Six hundred adult patients were included and 65.5% of them were men. Sixty patients had minimal lung damage (< 25%), 105 patients had mild lung damage (25-50%), 186 had severe lung damage (50-75%) and 193 patients had very severe lung damage (> 75%). A total of 210 patients (35%) developed AKI, of whom 78 (37.2%) had mild AKI (stage 1) and 132 (62.8%) severe AKI (stages 2 and 3). Patients in the severe and mild AKI groups had a higher rate of comorbidities, especially hypertension (mild AKI [46.2%] vs. severe AKI [36.4%] vs. no AKI [27.4%], p = 0.002) and diabetes (mild AKI [52.6%] vs. severe AKI [33.3%] vs. no AKI [26.4%], p < 0.001). During hospitalization, 23.3% of patients with AKI received kidney replacement therapy. In-hospital mortality was observed in 51.3% for mild AKI, 55.3% for severe AKI and 21% in patients who did not have AKI (p < 0.001). Conclusion Our findings revealed that not only severe AKI, but also mild AKI was correlated to in-hospital mortality. Whatever the severity of the kidney impairment, it remains a major prognostic element.

Introduction: Coronavirus disease 2019 (COVID-19) is a worldwide pandemic systemic infection that is responsible for serious coagulopathies similar to disseminated intravascular coagulation. Case Presentation: The authors report the case of a COVID-19 patient who presented with phlegmasia cerulea dolens (PCD) of the left lower limb, so he benefited from aponeurotomies of the internal and anterolateral muscular compartments. Clinical Discussion: The severe acute respiratory syndrome coronavirus 2 involves an inflammatory process in thrombotic events in COVID-19 patients, including a cytokine storm. PCD evolves in three semiological phases: venous stasis, weakening of the pulses, and the constitution of major ischemia. In the literature, the authors find many reports that have been published regarding increased thrombus formation in COVID-19 patients; these include DVT formation, pulmonary embolism, and stroke. Nevertheless, publications concerning PCD in COVID-19 patients remain rare. Conclusion: Although the severe acute respiratory syndrome coronavirus 2 remains a thrombogenic pathology, systematic anticoagulation is the subject of hypothesis. Hence the importance of regular monitoring of markers of vascular thrombosis.

Introduction: Diclofenac sodium is a nonsteroidal anti-inflammatory, the injection of which by the intra-arterial route can lead to serious vascular complications, including limb ischemia. Case presentation: We report the case of accidental intra-arterial injection of diclofenac sodium in the brachial artery leading to acute limb ischemia. Clinical discussion: Iatrogenic intra-arterial injection is rarely reported in the literature; however, it is toxic and can lead to limb amputation. Only two cases of intra-arterial injection of diclofenac have been reported in the literature. The proposed pathophysiological mechanism is vasospasm, intravascular thrombosis, and chemical endoarteritis. The most common anatomical location in accidental intra-arterial injection is the antecubital fossa, where branches of the ulnar and brachial arteries are more superficial. Conclusion: The injection of medication must be as careful as possible, since the intra-arterial injection can affect the functional prognosis of the organ.